Will a needle leak cause hand numbness?
Hello, doctor.
I am a nurse.
A few months ago, I administered an intravenous injection to a patient.
His veins were difficult to access, so I noticed a vein on the inner side of his wrist (the area where we usually check the pulse) that seemed suitable for the injection.
I used a 27-gauge scalp vein needle to administer the medication.
After starting the push, he reported pain, but I didn't see any swelling.
Considering he often complained of pain in the past, I continued to push the medication.
He then reported pain again, and when I aspirated, there was no blood return, so I removed the needle and had another colleague take over.
He began to complain to my colleague about numbness and pain at the site where I had injected him.
After the procedure, he reported this to the doctor, who advised him to rest, suggesting it would improve.
However, a few days later, he returned, stating that his hand from the injection site was still numb.
He mentioned that he consulted a physician at a Chinese medicine clinic, who told him that his hand needed to rest for six months.
I would like to ask, is it really possible for an injection to cause prolonged numbness like this? Additionally, since his hand did not swell during the medication push, where could the medication have gone if it had leaked?
Kunhuo, 20~29 year old female. Ask Date: 2016/10/22
Dr. Gao Chunde reply Neurology
If the needle unfortunately injures a nerve at the moment of insertion, the patient will experience intense pain or a sensation similar to an electric shock.
However, it seems that is not the case for you.
Most likely, what is gradually occurring is that the medication, which did not enter the blood vessel, is located adjacent to the nerve.
This results in simple compression, and as the medication is naturally absorbed, the pressure is relieved, allowing the nerve to gradually recover.
However, if the medication has neurotoxic effects or harms surrounding tissues, we need to consider the potential damage caused by the extravasated medication itself, which would be more complex.
Reply Date: 2016/10/22
More Info
Needle leakage during intravenous (IV) injection can indeed lead to complications, including prolonged hand numbness, although the exact mechanisms and outcomes can vary based on several factors. When an IV injection is performed, the goal is to deliver medication directly into the bloodstream through a vein. However, if the needle is not properly positioned within the vein, or if there is a leakage of the medication into the surrounding tissue (a situation often referred to as "extravasation"), it can lead to various adverse effects.
In your case, the patient experienced pain during the injection, which is a common indication that something may not be right. Pain can occur for several reasons, including irritation from the medication itself, improper needle placement, or even the needle touching the surrounding tissues. The fact that you did not observe swelling at the time of the injection does not rule out the possibility of extravasation. Some medications can cause irritation or inflammation without causing immediate swelling, especially if they are injected into the subcutaneous tissue rather than directly into the vein.
When medication leaks into the surrounding tissue, it can cause localized inflammation, which may lead to symptoms such as pain, numbness, or tingling. In some cases, if the medication is an irritant or if it causes tissue damage, it can lead to more severe complications, including nerve injury. Nerve damage can result in prolonged symptoms such as numbness or weakness in the affected area. This could explain why the patient reported persistent numbness in the hand days after the injection.
As for the question of where the medication went if it leaked out, it typically disperses into the surrounding tissues. Depending on the volume and type of medication, it may be absorbed slowly over time, which can lead to delayed effects. In some cases, if a significant volume of medication leaks out, it may not have the intended therapeutic effect, leading to the need for additional doses or alternative treatments.
In terms of the patient's experience of needing to rest the hand for an extended period, this could be a recommendation based on the physician's assessment of potential nerve involvement or tissue injury. While it may seem excessive, some injuries, particularly those involving nerves, can take time to heal, and rest is often advised to prevent further irritation or damage.
To summarize, needle leakage during IV injection can potentially cause prolonged numbness or other symptoms, especially if there is nerve involvement or tissue irritation. It is crucial for healthcare providers to monitor patients closely during and after IV injections, especially in cases where the veins are difficult to access. If a patient reports pain or unusual symptoms, further evaluation may be necessary to determine the cause and appropriate management. In your situation, it would be advisable to discuss the case with your supervising physician or a clinical educator to ensure that all safety protocols are followed in the future and to gain insights into managing similar situations.
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